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Total Parathyroidectomy and Autotransplantation in Secondary Hyperparathyroidism
Martin F. Mozes, MD;
William D. Soper, MD;
Olga Jonasson, MD;
Gordon R. Lang, MD
Arch Surg. 1980;115(4):378-385.
Abstract
• Sixteen patients with chronic renal failure and symptomatic secondary hyperparathyroidism underwent total parathyroidectomy. Sixteen to 25 fragments of parathyroid tissue measuring 1 cu mm were autotransplanted into the brachioradial muscle. Evidence of "take" of the autotransplant was present in all patients, although four patients still have hypocalcemia and require calcium and vitamin D supplementation. Three patients have experienced late diminution of autotransplant function. Symptomatic improvement occurred promptly in 15 of the 16 patients. Two patients with persistently elevated parathormone levels were treated by partial excision of the implant, and one patient whose autograft functioned inadequately was successfully treated by implantation of cryopreserved autologous parathyroid tissue. Total parathyroidectomy with autotransplantation of parathyroid fragments to the forearm is the preferred surgical procedure for secondary hyperparathyroidism.
(Arch Surg 115:378-385, 1980)
Author Affiliations
From the Division of Transplantation Surgery, Department of Surgery, Abraham Lincoln School of Medicine, University of Illinois Medical Center, Chicago (Drs Mozes, Soper, and Jonasson); and the Department of Medicine, St Joseph's Hospital, Chicago (Dr Lang).
Footnotes
Accepted for publication Nov 30, 1979.
Read before the 87th annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 12, 1979.
Reprint requests to Department of Surgery, University of Illinois Medical Center, PO Box 6998, Chicago, IL 60680 (Dr Mozes).
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